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Authors Posts by Melissa Dehoff

Melissa Dehoff

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Melissa Dehoff is responsible for all medical rehabilitation and brain injury service issues. Ms. Dehoff attends multiple state-level meetings to advocate on behalf of members on brain injury and rehabilitation issues and is a member of the Department of Health Traumatic Brain Injury Advisory Board.

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Congressman Brett Guthrie, Chairman of the House Committee on Energy and Commerce, and Congressman Morgan Griffith, Chairman of the Subcommittee on Health, recently announced a hearing “Legislative Proposals to Support Patient Access to Medicare Services.”

This Subcommittee on Health hearing will be held on January 8, 2026, at 10:15 am to discuss legislation focused on improving Medicare payment policies and expanding access to care for seniors.

The hearing will focus on the following bills:

  • H.R. 1703, Choices for Increased Mobility Act of 2025 (Rep. Joyce – PA)
  • H.R. 2005, DMEPOS Relief Act of 2025 (Rep. Miller-Meeks)
  • H.R. 2172, Preserving Patient Access to Home Infusion Act (Rep. Buchanan)
  • H.R. 2477, Portable Ultrasound Reimbursement Equity Act of 2025 (Rep. Van Duyne)
  • H.R. 2902, Supplemental Oxygen Access Reform (SOAR) Act of 2025 (Rep. Valadao)
  • H.R. 5243, To amend title XVIII of the Social Security Act to increase data transparency for supplemental benefits under Medicare Advantage. (Rep. McClellan)
  • H.R. 5269, Reforming and Enhancing Sustainable Updates to Laboratory Testing Services (RESULTS) Act of 2025 (Rep. Hudson)
  • H.R. 5347, Health Care Efficiency Through Flexibility Act (Rep. Buchanan)
  • H.R. 6210, Senior Savings Protection Act (Rep. Matsui)
  • H.R. 6361, Ban AI Denials in Medicare Act (Rep. Landsman)

The hearing will be open to the public as well as livestreamed. Questions about the hearing should be directed to Annabelle Huffman.

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Following the creation of the Rural Health Transformation (RHT) Program under President Trump’s Working Families Tax Cut legislation, the Centers for Medicare and Medicaid Services (CMS) has announced the establishment of the Office of Rural Health Transformation (ORHT). This new office will be located within the Center for Medicaid and CHIP Services (CMCS) and will continue overseeing the RHT Program. The RHT Program is a $50 billion initiative to strengthen rural health systems and expand access to care nationwide. As noted in RCPA’s Alert from December 30, 2025, Pennsylvania will receive nearly $200 million in 2026.

ORHT, which announced approved awardees on December 29, 2025, will guide states in implementing their rural health transformation plans, provide technical assistance, coordinate federal and state partnerships, and ensure strong oversight and accountability throughout the five-year program, which will run through September 30, 2031.

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Businesswoman using smartphone with monthly calendar to plan 2025 activities. Scheduling and organizing plans. Technology and business concept.

Due to scheduling conflicts, the March 2026 date for the Long-Terms Services and Supports Subcommittee (LTSS) meeting has been changed. The meeting has been changed from March 4, 2026, to March 11, 2026. The meeting will be held via webinar and remote streaming, from 10:00 am – 1:00 pm.

Questions and comments may be submitted electronically.

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The Centers for Medicare & Medicaid Services (CMS), in partnership with the Department of Labor and the Department of the Treasury (the Departments), included major updates to the health care price transparency rules established during President Trump’s first term in a proposed rule published in today’s Federal Register. The proposed rule is in line with Executive Order 14221, which ensures health care pricing data is not only public but impactful and actionable.

Key improvements include:

  • Requiring plans and issuers to exclude from the In-network Rate Files certain data for services providers would be unlikely to perform.
  • Reorganizing In-network Rate Files by provider network rather than by plan, cutting redundancy, and aligning with how most hospitals report data pursuant to the Hospital Price Transparency requirements.
  • Requiring Change-log and Utilization Files so users can easily identify what has changed from one In-network Rate File to the next and have clear information on which in-network providers are actively furnishing which items and services.
  • Reducing reporting cadence for In-network Rate and Allowed Amount Files from monthly to quarterly, significantly reducing burden while maintaining meaningful transparency.
  • Increasing the amount of out-of-network pricing information reported by reorganizing Allowed Amount files by health insurance market type, reducing the claims threshold to 11 or more claims, and increasing the reporting period from 90 days to 6 months and the lookback period of data from 180 days to 9 months.

The Departments are proposing these changes to open the door for more organizations, including those with fewer technical resources, to analyze pricing data, build consumer-friendly tools, and drive competition across the health care industry.

Under the proposal, group health plans and health insurance issuers would be required to provide the same detailed cost-sharing information whether viewed online, or in print or provided by telephone, upon request. This modernization would ensure that transparency is not limited by internet access or digital literacy. Further, updated disclosures will take into account new federal protections against balance billing under the No Surprises Act. These disclosures would ensure patients understand their rights and potential financial responsibilities before they seek care.

Additional information is provided on the CMS fact sheet. Feedback and comments on the proposed rule will be accepted until February 23, 2026.

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The agenda and link to join the January 7, 2026, Long-Term Services and Supports (LTSS) Subcommittee meeting have been released. The call on January 7, 2026, will be held via webinar and remote streaming only and will take place from 10:00 am – 1:00 pm.

A few of the key agenda topics, in addition to an update from the Office of Long-Term Living’s (OLTL) Deputy Security, include information being shared by OLTL on the 2026 OBRA Waiver renewal and the Community HealthChoices (CHC) Waiver amendment. Additionally, there will be a presentation from OLTL’s Enrollment Unit on enrollment and redeterminations/data requests.

To participate in the meeting, the information is below:
Conference line — Bridge Number: 1 (415) 655-0052 PIN: 571-523-182#
Webinar Link
Remote Streaming Link

Comments and questions may be sent electronically.

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The Centers for Medicare and Medicaid Services (CMS) recently published an errata document to the inpatient rehabilitation facility patient assessment instrument (IRF-PAI) Manual, Version 4.2, related to the coding of items J1750, J1800, and J1900. This errata document was issued to update guidance related to the Falls with Major Injury (FMI) measure in the IRF Quality Reporting Program (QRP), which is effective on January 1, 2026. Specifically, the guidance related to item J1900 Number of Falls Since Admission item has revisions to the definition of Injury (except Major) and Major Injury.

CMS also released the official Technical Specification Report for the Falls with Major Injury (FMI) measure. This report incorporates feedback received during the cross-setting Technical Expert Panel (TEP) held in May 2025. The report provides an overview of the measure, a high-level summary of the key features of the re-specified measure, a description of the methodology used to construct the FMI measure, and an overview of measure testing results. Additional guidance and related updates to the IRF-PAI Manual, Quality Measure Calculations and Reporting User’s Manual, and public reporting timelines will be provided at a future date. The report is available in the Downloads section on the IRF QRP Measures Information web page.

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At the December 4, 2025, Medicare Payment Advisory Commission (MedPAC) annual session on payment adequacy for Medicare providers, draft fiscal year (FY) 2027 payment recommendations were issued. The recommendations, “Assessing Payment Adequacy and Updating Payments: Inpatient Rehabilitation Facility (IRF) Services,” were shared. Included in their presentation were their findings on admissions, financial performance by IRF provider type, quality metrics, and other relevant data points. In addition to the payment-focused sessions, the meeting included a general session on post-acute care trends and “key issues,” which compared various patient- and payment-focused data across IRFs, skilled nursing facilities (SNF), and home health agencies (HHA).

During the IRF payment session, MedPAC advanced a draft recommendation calling for Congress to reduce the 2026 Medicare base payment rate for IRFs by 7 percent in FY 2027. This draft recommendation is identical to last year’s recommendation and marks an increase over the FY 2025 recommendation (a 5% cut to the Medicare base payment rate) and the FY 2024 finalized recommendation (3% cut).

MedPAC’s recommendations are advisory in nature, and most of MedPAC’s work can only be implemented via Congressional action. RCPA will monitor the status of these recommendations through close collaboration with the American Medical Rehabilitation Providers Association (AMRPA).

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